Oregon heart transplant recipient hopes for kidney

Monday

May 9, 2011 at 12:25 AM

Jeremy Koertje dreams of working in the computer industry.

Kathy Aney

Jeremy Koertje dreams of working in the computer industry.

These days, however, the 26-year-old would settle for taking his skateboard for a spin, tossing a football with his brothers or simply shaking the fatigue and nausea that have become his constant companion.

The Boardman man received a heart transplant more than 24 years ago. As a 1-year-old, Jeremy was the first child under the age of 10 to have a heart transplant performed in the Pacific Northwest. Jeremy knows he has beaten the odds, but over the years, anti-rejection drugs took their toll on his kidneys. Jeremy is weak and recently started home dialysis to clean his blood.

Jeremy's mother, Mary Koertje, remembers the day the saga began 24 years ago.

"He came down with strep and it went to his heart," she said. "Ten days later, he had a heart transplant."

That's the short version.

Mary and her husband Howard had lost another son, Jonathan, in 1984 after he came down with a flu-like illness at the age of 21 months. Two days later, Jonathan died. Three years later, Jeremy was following his brother's footsteps at almost the same age.

"It was deja vu," Mary recalled. "We thought, here we go again."

Before the heart became available, Jeremy lay in a crib at Oregon Health & Science University where his parents and nurses urged him to stay still to keep from stressing his heart. Within a few days of getting his name on the transplant list, surgeons transplanted the heart of a young accident victim into Jeremy. The little boy, with a brand-new heart beating in his chest, began a new life.

Living with a transplanted heart required Jeremy to take anti-rejection drugs and a kitchen drawer full of other medications. Prescribing optimal doses of anti-rejection drugs is a delicate dance. Not enough medication and the body rejects the heart. Too much and the kidneys are overwhelmed. Jeremy's kidneys finally started failing a couple of years ago. His kidney function gradually dropped to 10 percent and his feet swelled up to the size of footballs.

Jeremy's bedroom closet now holds an IV stand and cardboard boxes filled with sugar water solution. Four times a day, he fills his abdominal cavity with fluid through a permanent catheter in his stomach. The solution draws out waste and extra fluid. After several hours, he drains the now-toxic solution and refills.

The procedure is hard on his heart and hard on his psyche.

Jeremy escapes his reality by firing up his Xbox. While Jeremy's human body is grounded, his on-screen persona races across futuristic landscapes, slaying legions of enemies. The Xbox keeps his frustration at bay, but being trapped in a malfunctioning body gets wearing.

"I get really down sometimes," he said.

Mary is never far from Jeremy. She quit her job as school librarian to help her son with dialysis and ferry him to medical appointments. Finding Jeremy a kidney is high on her list. She is not a match for her son. Howard and Jeremy's older brothers, Josh and Cory, are also unsuitable donors.

Mary is checking all paths that might lead to a new kidney. Jeremy will likely go on OHSU's transplant list after he shakes off the effects of a recent virus. Mary knows that route could take years and hopes kind friends or strangers will offer to test for compatibility.

She is also looking into a group called Alliance for Paired Donation. The organization solves the incompatibility problem by exchanging donors such as Mary who are willing to donate, but aren't a match for their own family member. For example, a chain of 10 donations started after an altruistic donor gave a kidney to a woman from Phoenix. The woman's husband donated his kidney to a stranger in Ohio, whose mother donated to a man in Maryland and so on.

One way or another, Jeremy's mom is keeping the faith.

"My kids are everything to me," she said. "I'll fight with everything I have."